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Chun and Yoon: A Short-Term Analysis of Parameters Affecting the Outcome of Sacral Neuromodulation
Original Article
Lower Urinary Tract Dysfunction
Korean Journal of Urology

Korean Journal of Urology 2009; 50(2): 135-139.

Published online: 24 February 2009

DOI: https://doi.org/10.4111/kju.2009.50.2.135

A Short-Term Analysis of Parameters Affecting the Outcome of Sacral Neuromodulation

Kye Min Chun, Hana Yoon

Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea.

Correspondence to: Hana Yoon. Department of Urology, Ewha Womans University School of Medicine, 911-1, Mok-dong, Yangcheon-gu, Seoul 158-710, Korea. TEL: 02-2650-5157, FAX: 02-2654-3682, wowhana@ewha.ac.kr

Received 26 August 2008       Accepted 10 October 2008

Copyright © The Korean Urological Association, 2009

Abstract

Purpose

Sacral neuromodulation has become an effective option for controlling intractable symptoms of overactive bladder: urgency and urge incontinence. However, it has its limitations in that an intermittent pulse generator (IPG) is insertable only in patients with symptom improvement of at least 50%. In this study, we aimed to investigate the parameters that predict surgical outcomes.

Materials and Methods

Data from 31 candidates for sacral neuromodulation were retrospectively analyzed. Twenty patients out of 31 candidates had satisfactory symptom improvement after tinned lead test implantation, which resulted in IPG implantation. Data and neural stimulation parameters were compared and analyzed between successful IPG implants (group 1) and test failures (group 2).

Results

The percentage of female patients was higher in the IPG implant group (group 1: 95%, group 2: 64%). There was a significant difference in symptom duration, between the two groups (group 1: 40.5 months, group 2: 91 months). There was a significant difference in the number of episodes of urgency between the two groups (group 1: 6.83/day, group 2: 9.66/day, p=0.012), and severity of urgency showed significant difference between two groups (group 1<group 2, p=0.027).

Conclusions

In females, the severity and duration of symptoms may be factors predicting poor response to neuromodulation. Although there is a need for further data analysis, this study suggests that the proper selection of surgical time is important in controlling patients' lower urinary tract symptoms by neuromodulation.

Keywords: Neuromodulation, Prognosis factor, Outcome

Figures and Tables

Fig. 1
Differences in frequency (p=0.684) and urgency (p=0.012) between group 1 (IPG insertion) and group 2 (IPG insertion fail). IPG: intermittent pulse generator.
kju-50-135-g001
Fig. 2
Differences in nocturia (p=0.454) between group 1 (IPG insertion) and group 2 (IPG insertion fail). IPG: intermittent pulse generator.
kju-50-135-g002
Fig. 3
Differences in intensity of urgency (p=0.027) between group 1 (IPG insertion) and group 2 (IPG insertion fail). IPG: intermittent pulse generator.
kju-50-135-g003
Table 1
Patient characteristics of group 1 (IPG insertion) and group 2 (IPG insertion fail)
kju-50-135-i001

IPG: intermittent pulse generator, HTN: hypertention, DM: diabetes mellitus, SCD: spinal cord disease, OAB: overactive bladder, IC: interstitial cystitis, NB: neurogenic bladder

Table 2
Difference between group 1 (IPG insertion) and group 2 (IPG insertion fail)
kju-50-135-i002

IPG: intermittent pulse generator, VV: voided volume, RU: residual urine

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